Healthcare professionals with the heaviest COVID-19 workloads are at a high risk for both physical and mental health issues, according to a new study in the Journal of Pain and Symptom Management. Researchers examined 140 intensive care unit (ICU) nurses working in Wuhan, China at the start of the coronavirus outbreak and reported three distinct symptom clusters:
- Breathing and sleep disturbances: dizziness, sleepiness, dyspnea
- Gastrointestinal symptoms and pain: nausea, headache
- General symptoms: xerostomia, fatigue, chest discomfort
These findings are further supported by a cross-sectional study, published in the Journal of the American Medical Association (JAMA), showing the high rate at which a sample of more than 1,200 HCPs in China reported symptoms for depression (50.4%), anxiety (44.6%), insomnia (34.0%) and distress (71.5%).
What is compassion fatigue?
Unrelenting demands, overcrowded hospitals, challenging patient flow, limited beds and a lack of personal protective equipment can produce a constellation of mental and physical signs and symptoms, collectively known as compassion fatigue. As the JAMA study demonstrated, healthcare professionals who work among high COVID-19 case numbers are at risk for the worst mental health outcomes. Yet, in the midst of a crisis, public health measures don’t always prioritize worker protection.
What can providers do?
During this time, taking steps to manage stress is just as important as managing your physical health. The American Psychiatric Nurses Association recommends the following:
- Check in on your mental health. Acknowledge and understand that you will have reactions, such as stress, anxiety and grief, to the situations you are encountering.
- Schedule time for self-care.
- Activate your parasympathetic nervous system via breathing exercises, regular meals and maintaining social connections with family and friends.
- Look for signs/symptoms of compassion fatigue in staff and colleagues, and connect affected staff to on-site counseling services.
- If you’re a facility administrator, consider providing designated wellness spaces and sleeping areas, as well as regular meals for frontline healthcare professionals.
Finally, pay attention to self-compassion. Seek help if you need it. In addition to recommendations and resources in the COVID-19 Center, the Substance Abuse and Mental Health Services Administration offers a 24/7 distress hotline, and free crisis counseling is always available at the Crisis Text Line.
- Symptom Cluster of ICU nurses treating COVID-19 pneumonia patients, The Journal of Pain and Symptom Management.
- Factors Associated With Mental Health Outcomes Among Health Care Workers Exposed to Coronavirus Disease 2019, JAMA Network Open.
- Compassion fatigue in nursing: A concept analysis, PubMed.